KEENAN SANDOUK

PROVIDENCE, RI
NPI1972111029
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-07-15
Last Update Date2020-07-15
Business Address
KEENAN SANDOUK DMD
830 CHALKSTONE AVE
PROVIDENCE, RI 02908-4734
Phone number: 401-273-7100
Mailing Address
KEENAN SANDOUK DMD
830 CHALKSTONE AVE
PROVIDENCE, RI 02908-4734
Phone number: 401-273-7100
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